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Lolk K, Werenberg Dreier J, Christensen J. Individual and neighborhood-level socioeconomic deprivation and risk of epilepsy after traumatic brain Injury: A register-based cohort study. Epilepsy Behav 2024; 156:109807. [PMID: 38678986 DOI: 10.1016/j.yebeh.2024.109807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 04/21/2024] [Accepted: 04/21/2024] [Indexed: 05/01/2024]
Affiliation(s)
- Kasper Lolk
- National Centre for Register-based Research, Aarhus BSS, Aarhus University, Denmark; Centre for Integrated Register-based Research, CIRRAU, Aarhus University, Aarhus, Denmark.
| | - Julie Werenberg Dreier
- National Centre for Register-based Research, Aarhus BSS, Aarhus University, Denmark; Centre for Integrated Register-based Research, CIRRAU, Aarhus University, Aarhus, Denmark
| | - Jakob Christensen
- National Centre for Register-based Research, Aarhus BSS, Aarhus University, Denmark; Department of Neurology, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Denmark
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Chen HY, Möller H, Senserrick TM, Rogers KD, Cullen P, Ivers RQ. Young drivers' early access to their own car and crash risk into early adulthood: Findings from the DRIVE study. ACCIDENT; ANALYSIS AND PREVENTION 2024; 199:107516. [PMID: 38401242 DOI: 10.1016/j.aap.2024.107516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 12/04/2023] [Accepted: 02/20/2024] [Indexed: 02/26/2024]
Abstract
INTRODUCTION Car ownership at early licensure for young drivers has been identified as a crash risk factor, but for how long this risk persists is unknown. This study examined crash hazard rates between young drivers with their own vehicle and those who shared a family vehicle at early licensure over 13 years. METHODS The DRIVE study, a 2003/04 survey of 20,806 young novice drivers in New South Wales, Australia was used to link to police crash, hospital and death records up to 2016. The first police-reported crash and crash resulting in hospitalisation/death was modelled via flexible parametric survival analysis by type of vehicle access at baseline (own vs. shared family vehicle). RESULTS After adjusting for covariates, drivers with their own vehicle at early licensure had an almost 30 % increased hazard rate for any crash after one year (95 % CI:1.16-1.42) compared with those who only had access to a family car and this attenuated but remained significantly higher until year 7 (HR: 1.1, 95 % CI: >1.00-1.20). For crashes resulting in hospitalisation or death, an almost 15-times higher hazard (95 % CI: 1.40-158.17) was observed at the start of follow up, remaining 50 % to year 3 (95 % CI:1.01-2.18). CONCLUSIONS Parents and young drivers should be aware of the increased risks involved in car ownership at early licensure. Development of poorer driving habits has been associated with less parental monitoring at this time. Graduated Driving Licensing educators, researchers and stakeholders should seek to address this and to identify improved safety management options.
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Affiliation(s)
- Huei-Yang Chen
- Evidence Directorate, Agency for Clinical Innovation, Sydney, NSW 2065, Australia.
| | - Holger Möller
- School of Population Health, University of New South Wales, Sydney, NSW 2052, Australia; The George Institute for Global Health, Sydney, NSW 2042, Australia.
| | - Teresa M Senserrick
- Western Australian Centre for Road Safety Research, The University of Western Australia, Perth, WA 6009, Australia.
| | - Kris D Rogers
- School of Population Health, University of New South Wales, Sydney, NSW 2052, Australia; The George Institute for Global Health, Sydney, NSW 2042, Australia; Graduate School of Health, The University of Technology Sydney, Sydney, NSW 2006, Australia.
| | - Patricia Cullen
- School of Population Health, University of New South Wales, Sydney, NSW 2052, Australia; The George Institute for Global Health, Sydney, NSW 2042, Australia; Ngarruwan Ngadju: First Peoples Health and Wellbeing Research Centre, University of Wollongong, NSW 2522, Australia.
| | - Rebecca Q Ivers
- School of Population Health, University of New South Wales, Sydney, NSW 2052, Australia; The George Institute for Global Health, Sydney, NSW 2042, Australia.
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Verma S, Wilson F, Wang H, Smith L, Tak HJ. Impact of Community Socioeconomic Characteristics on Emergency Medical Service Delays in Responding to Fatal Vehicle Crashes. AJPM FOCUS 2023; 2:100129. [PMID: 37790947 PMCID: PMC10546577 DOI: 10.1016/j.focus.2023.100129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Introduction This study aimed to determine the impact of community socioeconomic status on emergency medical services' response time for fatal vehicle crashes. Methods Authors used the 2019 National Highway Traffic Safety Administration Fatality Analysis Reporting System and 2019-2020 Area Health Resource Files to obtain emergency medical services' time intervals and county socioeconomic characteristics (e.g., median household income, availability of trauma centers, and rurality), generating a study sample of 18,540 individuals involved in fatal vehicle crashes between January and December 2019. Generalized linear models with log-link and Gamma-family were used to obtain estimates, and other variables were adjusted in the model. Results Both the mean time of the emergency medical service arrival to the site of the crash and the mean transport time from the crash site to hospital varied by county SES. Counties with a higher mean household income had 12% shorter emergency medical services' arrival times and up to 7% shorter emergency medical services' hospital transport times than counties with lower SES. The emergency medical services' hospital transport times by emergency medical services also varied by proximity to trauma centers and were 15% shorter in counties that had ≥2 trauma centers than in counties without trauma centers. Conclusions This study shows socioeconomic disparities in emergency medical service rescue time for fatal vehicle crashes. Community characteristics play a major role in emergency medical services' arrival time intervals. Prior research demonstrated a strong link between the timeliness of emergency medical service response and the likelihood of survival in fatal motor vehicle accidents. These findings showing that socioeconomically disadvantaged areas and those lacking trauma facilities had slower emergency medical service rescue times, suggest that socioeconomic status may be a predictor of mortality in fatal motor vehicle accidents. Effective emergency medical services are essential to reduce the morbidity and mortality among motor vehicle crash victims; however, disparities exist in the timeliness of these services by geographic and socioeconomic county characteristics. Further research is urgently needed to inform policy interventions.
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Affiliation(s)
- Sachi Verma
- College of Public Health, Department of Health Services Research & Administration, University of Nebraska Medical Center, Omaha, Nebraska
| | - Fernando Wilson
- Matheson Center for Health Care Studies, University of Utah, Salt Lake City, Utah
- Department of Population Health Sciences, University of Utah, Salt Lake City, Utah
| | - Hongmei Wang
- College of Public Health, Department of Health Services Research & Administration, University of Nebraska Medical Center, Omaha, Nebraska
| | - Lynette Smith
- College of Public Health, Department of Biostatistics, University of Nebraska Medical Center, Omaha, Nebraska
| | - Hyo Jung Tak
- College of Public Health, Department of Health Services Research & Administration, University of Nebraska Medical Center, Omaha, Nebraska
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Senserrick T, Möller H, Boufous S, Stevenson M, Williamson A, Patton G, McLean R, Chen HY, Cullen P, Woodward M, Ivers R. Learning With a Supervisor Who has Traffic Offences and Young Driver Crashes: The DRIVE Study 13-Year Follow-Up. J Adolesc Health 2023; 73:859-865. [PMID: 37642621 DOI: 10.1016/j.jadohealth.2023.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 06/20/2023] [Accepted: 06/23/2023] [Indexed: 08/31/2023]
Abstract
PURPOSE Young learner drivers commonly must record substantial supervised practice driving before independent licensure. Supervisory driver requirements can be limited or highly regulated, yet research is lacking on the effectiveness of different approaches. The current objective was to explore whether young drivers who were mostly supervised by someone who they perceived had traffic offences versus no offences had different crash records over a period of 13 years postlicensing. METHODS DRIVE is an Australian prospective cohort study of more than 20,000 drivers who were aged 17-24 years and newly licensed during 2003-2004. They completed detailed baseline questionnaires, including whether the person they identified as supervising their learner driving the most had perceived traffic offences in the past 12 months. Responses were linked to their state crash, hospitalization, and death records to 2016. A parametric survival model was created to calculate hazard ratios of time to crash for those reporting that their supervisor had 0 versus 1 and 0 versus 2+ perceived offences, adjusting for the participants' prior crash history and other covariates. RESULTS After adjusting for covariates, 369 participants reporting supervisory drivers with 2+ perceived offences, compared to 15,451 participants reporting no such offences, had up to 1.67 (95% confidence interval 1.10-2.53 at 6 months) times the rate of any crash for the first 2.5 years and up to 2.01 (95% confidence interval 1.26-3.19 at 3.5 years) times the rate of crashes resulting in injury for 5.5 years. DISCUSSION Although overall supervision by a driver with two or more perceived offences was low, further attention is needed to ensure improved supervised driving experiences, with mentoring programs and professional instructor partnerships worthy of exploration.
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Affiliation(s)
- Teresa Senserrick
- Western Australian Centre for Road Safety Research, School of Psychological Science, The University of Western Australia, Western Australia, Australia; Centre for Accident Research and Road Safety - Queensland, School of Psychology and Counselling, Queensland University of Technology (QUT), Kelvin Grove, Queensland, Australia.
| | - Holger Möller
- School of Population Health, The University of New South Wales (UNSW Sydney), Kensington, New South Wales, Australia; The George Institute for Global Health, The University of New South Wales (UNSW Sydney), Kensington, New South Wales, Australia
| | - Soufiane Boufous
- Transport and Road Safety Research, School of Aviation, The University of New South Wales (UNSW Sydney), Kensington, New South Wales, Australia
| | - Mark Stevenson
- Transport Health and Urban Design Research Lab, Melbourne School of Design, The University of Melbourne, Parkville, Victoria, Australia; Faculty of Engineering and Information Technology, The University of Melbourne, Parkville, Victoria, Australia
| | - Ann Williamson
- Transport and Road Safety Research, School of Aviation, The University of New South Wales (UNSW Sydney), Kensington, New South Wales, Australia
| | - George Patton
- Centre for Adolescent Development, The Royal Children's Hospital, Murdoch Children's Research Institute and Department of Paediatrics, The University of Melbourne, Parkville, Australia
| | - Rebecca McLean
- Department of Population Health, University of Otago, Christchurch, New Zealand
| | - Huei-Yang Chen
- Evidence, Agency for Clinical Innovation, St Leonards, New South Wales, Australia
| | - Patricia Cullen
- School of Population Health, The University of New South Wales (UNSW Sydney), Kensington, New South Wales, Australia; The George Institute for Global Health, The University of New South Wales (UNSW Sydney), Kensington, New South Wales, Australia; Ngarruwan Ngadju: First Peoples Health and Wellbeing Research Centre, School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, New South Wales, Australia
| | - Mark Woodward
- The George Institute for Global Health, School of Public Health, Imperial College London, London, United Kingdom
| | - Rebecca Ivers
- School of Population Health, The University of New South Wales (UNSW Sydney), Kensington, New South Wales, Australia; The George Institute for Global Health, The University of New South Wales (UNSW Sydney), Kensington, New South Wales, Australia
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Popa Ș, Ciongradi CI, Sârbu I, Bîcă O, Popa IP, Bulgaru-Iliescu D. Traffic Accidents in Children and Adolescents: A Complex Orthopedic and Medico-Legal Approach. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1446. [PMID: 37761407 PMCID: PMC10527870 DOI: 10.3390/children10091446] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/11/2023] [Accepted: 08/22/2023] [Indexed: 09/29/2023]
Abstract
Traffic accidents involving children and adolescents present complex challenges from both the medico-legal and orthopedic standpoints. Despite the implementation of road traffic safety laws, pediatric road traffic injuries continue to be a significant contributor to mortality rates, physical harm, and hospitalization on a global scale. For children and young people, automobile accidents are considered to be the primary culprit of mortality in developed nations. Even in highly developed nations, trauma is a significant factor in infant mortality. Each age category, from childhood to young adulthood, has its fracture patterns, as their skeletons are considerably different from those of adults. The consequences of traffic accidents extend beyond the immediate physical trauma. The medico-legal aspects surrounding these incidents add another layer of complexity, as legal repercussions may affect the responsible adult or parent, particularly in cases involving child fatalities. To effectively address traffic accidents in children and adolescents, a comprehensive approach is necessary. This approach should involve not only medical professionals but also legal experts and policymakers. Collaboration between orthopedic specialists, medico-legal professionals, law enforcement agencies, and relevant government bodies can facilitate the development and implementation of strategies aimed at prevention, education, the enforcement of traffic laws, and improved infrastructure. By addressing both the medical and legal aspects, it is possible to enhance road safety for children and adolescents, reducing the incidence of injuries and their associated long-term consequences. In this review, we aimed to summarize traffic accidents in children and adolescents from a complex orthopedic and medico-legal approach.
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Affiliation(s)
- Ștefan Popa
- 2nd Department of Surgery–Pediatric Surgery and Orthopedics, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania; (Ș.P.); (I.S.); (O.B.)
| | - Carmen Iulia Ciongradi
- 2nd Department of Surgery–Pediatric Surgery and Orthopedics, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania; (Ș.P.); (I.S.); (O.B.)
| | - Ioan Sârbu
- 2nd Department of Surgery–Pediatric Surgery and Orthopedics, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania; (Ș.P.); (I.S.); (O.B.)
| | - Ovidiu Bîcă
- 2nd Department of Surgery–Pediatric Surgery and Orthopedics, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania; (Ș.P.); (I.S.); (O.B.)
| | - Irene Paula Popa
- Department of Physiology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
| | - Diana Bulgaru-Iliescu
- 3rd Department of Medical Specialities–Legal Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania;
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Cullen P, Mőller H, Baffsky R, Martiniuk A, Senserrick T, Rogers K, Woodward M, Stevenson MR, McLean R, Sawyer S, Patton G, Ivers RQ. Self-harm in adolescence and risk of crash: a 13-year cohort study of novice drivers in New South Wales, Australia. Inj Prev 2023; 29:302-308. [PMID: 36813554 PMCID: PMC10423516 DOI: 10.1136/ip-2022-044807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 01/20/2023] [Indexed: 02/24/2023]
Abstract
INTRODUCTION Self-harm and suicide are leading causes of morbidity and death for young people, worldwide. Previous research has identified self-harm is a risk factor for vehicle crashes, however, there is a lack of long-term crash data post licensing that investigates this relationship. We aimed to determine whether adolescent self-harm persists as crash risk factor in adulthood. METHODS We followed 20 806 newly licensed adolescent and young adult drivers in the DRIVE prospective cohort for 13 years to examine whether self-harm was a risk factor for vehicle crashes. The association between self-harm and crash was analysed using cumulative incidence curves investigating time to first crash and quantified using negative binominal regression models adjusted for driver demographics and conventional crash risk factors. RESULTS Adolescents who reported self-harm at baseline were at increased risk of crashes 13 years later than those reporting no self-harm (relative risk (RR) 1.29: 95% CI 1.14 to 1.47). This risk remained after controlling for driver experience, demographic characteristics and known risk factors for crashes, including alcohol use and risk taking behaviour (RR 1.23: 95% CI 1.08 to 1.39). Sensation seeking had an additive effect on the association between self-harm and single-vehicle crashes (relative excess risk due to interaction 0.87: 95% CI 0.07 to 1.67), but not for other types of crashes. DISCUSSION Our findings add to the growing body of evidence that self-harm during adolescence predicts a range of poorer health outcomes, including motor vehicle crash risks that warrant further investigation and consideration in road safety interventions. Complex interventions addressing self-harm in adolescence, as well as road safety and substance use, are critical for preventing health harming behaviours across the life course.
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Affiliation(s)
- Patricia Cullen
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
- The George Institute for Global Health, Sydney, New South Wales, Australia
- Ngarruwan Ngadju: First Peoples Health and Wellbeing Research Centre, University of Wollongong, Wollongong, New South Wales, Australia
| | - Holger Mőller
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Rachel Baffsky
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Alexandra Martiniuk
- The George Institute for Global Health, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Teresa Senserrick
- Centre for Accident Research and Road Safety - Queensland (CARRS-Q), Queensland University of Technology (QUT), Brisbane, Queensland, Australia
| | - Kris Rogers
- The George Institute for Global Health, Sydney, New South Wales, Australia
- Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Mark Woodward
- The George Institute for Global Health, Sydney, New South Wales, Australia
- The George Institute for Global Health, Imperial College London, London, UK
| | - Mark R Stevenson
- Transport Health and Urban Design Research Hub, The University of Melbourne, Melbourne, Victoria, Australia
| | - Rebecca McLean
- Department of Population Health, University of Otago Christchurch, Christchurch, New Zealand
| | - Susan Sawyer
- Department of Pediatrics, The University of Melbourne Faculty of Medicine Dentistry and Health Sciences, Melbourne, Victoria, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Centre for Adolescent Health, The Royal Children's Hospital, Melbourne, Victoria, Australia
| | - George Patton
- Department of Pediatrics, The University of Melbourne Faculty of Medicine Dentistry and Health Sciences, Melbourne, Victoria, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Centre for Adolescent Health, The Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Rebecca Q Ivers
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
- The George Institute for Global Health, Sydney, New South Wales, Australia
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Boufous S, Möller H, Patton G, Woodward M, Stevenson MR, Senserrick T, Mclean R, Cullen P, Wang A, Rogers K, Chen HY, Ivers RQ. Acculturation and risk of traffic crashes in young Asian-born Australian drivers. Inj Prev 2023; 29:74-78. [PMID: 36171076 DOI: 10.1136/ip-2022-044718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 09/10/2022] [Indexed: 01/28/2023]
Abstract
The study examines changes over time in crash risk differences between young Australian drivers born in Asia and those born in Australia.Data from the 2003 baseline survey of the DRIVE cohort of 20 806 young drivers aged 17-24 years were linked to police, hospital and death data up until 2016. The association between country of birth and crash was investigated using flexible parametric survival models adjusted for confounders.Six months after baseline, the crash risk in Asian-born drivers was less than half that of their Australian-born counterparts (mean HR, MHR 0.41; 95% CI 0.29 to 0.57), only to increase steadily over time to resemble that of Australian-born drivers 13 years later (MHR 0.94; 95% CI 0.66 to 1.36).This is likely to be associated with acculturation and the adoption by young Asian-born Australian drivers of driving behaviour patterns akin to those born locally. This needs to be considered in future road safety campaigns.
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Affiliation(s)
- Soufiane Boufous
- Transport and Road Safety Research, School of Aviation, Faculty of Science, University of New South Wales - Kensington Campus, Sydney, New South Wales, Australia
| | - Holger Möller
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia.,The George Institute for Global Health, University of New South Wales, Newtown, NSW, Australia
| | - George Patton
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Mark Woodward
- School of Public Health, The George Institute for Global Health, Imperial College London Faculty of Medicine, London, UK
| | - Mark R Stevenson
- Melbourne School of Design
- Faculty of Architecture Building and Planning Melbourne School of Population and Global Health
- Melbourne School of Engineering, University of Melbourne, Melbourne, Victoria, Australia
| | - Teresa Senserrick
- Centre for Accident Research and Road Safety - Queensland (CARRS-Q), Queensland University of Technology (QUT), Brisbane, Queensland, Australia
| | - Rebecca Mclean
- Department of Population Health, University of Otago, Christchurch, New Zealand
| | - Patricia Cullen
- School of Population Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Amy Wang
- School of Population Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Kris Rogers
- Graduate School of Health and School of Public Health, University of Technology Sydney, Broadway, New South Wales, Australia
| | - Huei-Yang Chen
- NSW Agency for Clinical Innovation, North Ryde, New South Wales, Australia
| | - Rebecca Q Ivers
- School of Population Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
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Chang YH, Hou WH, Wu KF, Li CY, Hsu IL. Risk of motorcycle collisions among patients with type 2 diabetes: a population-based cohort study with age and sex stratifications in Taiwan. Acta Diabetol 2022; 59:1625-1634. [PMID: 36103089 DOI: 10.1007/s00592-022-01967-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 08/29/2022] [Indexed: 11/01/2022]
Abstract
AIMS To investigate the overall and sex-age-specific absolute and relative risks of motorcycle collisions at road traffic accidents among patients with type 2 diabetes. METHODS A cohort study in Taiwan was conducted by following 989,495 patients with type 2 diabetes and the same number of matched controls recruited between 2010 and 2012 to the end of 2016. Collision events by motorcycle driver victims were identified from the Police-reported Traffic Accident Registry. Overall and sex-age-specific incidence rates of collision involving motorcycle driver victims were estimated under Poisson assumption. The Cox proportional hazard regression models were performed to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) of collision in association with type 2 diabetes. RESULTS Over an up to 7 years of follow-up, patients with type 2 diabetes had a higher incidence rate of motorcycle collision than controls at 1.16 and 0.89 per 100 person-years, respectively, which represented a significantly elevated HR of 1.28 (95% CI 1.27-1.30) after adjusting for potential confounders including various diabetic complications. The elevated HR was similarly seen in both men and women patients, and was significantly decreasing with increasing age regardless of sex. Little evidence supported the dose-response relationship between duration of type 2 diabetes and motorcycle collision risk. CONCLUSIONS After adjustment for common diabetic complications and comorbidities that could impair driving performance, patients with type 2 diabetes still suffered from increased risk of motorcycle collisions, regardless of sex, but was more evident in younger than in older patients.
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Affiliation(s)
- Ya-Hui Chang
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Wen-Hsuan Hou
- College of Medicine, National Cheng Kung University, Tainan, Taiwan
- School of Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taipei, Taiwan
- Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei, Taiwan
- Department of Geriatrics and Gerontology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ke-Fei Wu
- Department of Accounting Information, Chihlee University of Technology, New Taipei, Taiwan
- Department of Business Management, National Taichung University of Science and Technology, Taichung, Taiwan
| | - Chung-Yi Li
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - I-Lin Hsu
- Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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Socioeconomic Characteristics of Pediatric Traumatic Brain Injury Patients. Clin Neurol Neurosurg 2022; 221:107404. [DOI: 10.1016/j.clineuro.2022.107404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/28/2022] [Accepted: 07/30/2022] [Indexed: 11/20/2022]
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Sagar S, Stamatiadis N, Codden R, Benedetti M, Cook L, Zhu M. Socioeconomic and Demographic Factors Effect in Association with Driver's Medical Services after Crashes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159087. [PMID: 35897457 PMCID: PMC9331946 DOI: 10.3390/ijerph19159087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 07/20/2022] [Accepted: 07/21/2022] [Indexed: 02/01/2023]
Abstract
Motor vehicle crashes are the third leading cause of preventable-injury deaths in the United States. Previous research has found links between the socioeconomic characteristics of driver residence zip codes and crash frequencies. The objective of the study is to extend earlier work by investigating whether the socioeconomic characteristics of a driver’s residence zip code influence their likelihood of resulting in post-crash medical services. Data were drawn from General Use Model (GUM) data for police crash reports linked to hospital records in Kentucky, Utah, and Ohio. Zip-code-level socioeconomic data from the American Community Survey were also incorporated into analyses. Logistic regression models were developed for each state and showed that the socioeconomic variables such as educational attainment, median housing value, gender, and age have p-values < 0.001 when tested against the odds of seeking post-crash medical services. Models for Kentucky and Utah also include the employment-to-population ratio. The results show that in addition to age and gender, educational attainment, median housing value and rurality percentage at the zip code level are associated with the likelihood of a driver seeking follow-up medical services after a crash. It is concluded that drivers from areas with lower household income and lower educational attainment are more likely to seek post-crash medical services, primarily in emergency departments. Female drivers are also more likely to seek post-crash medical services.
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Affiliation(s)
- Shraddha Sagar
- University of Florida Transportation Institute, University of Florida, Gainesville, FL 32611, USA
- Correspondence:
| | | | - Rachel Codden
- School of Medicine, University of Utah, Salt Lake City, UT 84112, USA;
| | - Marco Benedetti
- Center for Injury Research & Policy, Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH 43215, USA; (M.B.); (M.Z.)
| | - Larry Cook
- Department of Pediatrics, University of Utah, Salt Lake City, UT 84112, USA;
| | - Motao Zhu
- Center for Injury Research & Policy, Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH 43215, USA; (M.B.); (M.Z.)
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Möller H, Cullen P, Senserrick T, Rogers K, Boufous S, Ivers RQ. Driving offences and risk of subsequent crash in novice drivers: the DRIVE cohort study 12-year follow-up. Inj Prev 2022; 28:396-404. [PMID: 35361665 PMCID: PMC9510411 DOI: 10.1136/injuryprev-2021-044482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 02/26/2022] [Indexed: 11/20/2022]
Abstract
Background Penalties are a key component to improve road user safety, but previous studies suggested that they might not be successful in reducing crashing in offending drivers. However, these studies were not able to consider important crash risk factors in the analysis that might confound the results. Using data from a large prospective cohort study of young drivers in New South Wales, Australia, we explored if novice drivers with driving offences have a higher rates of car crash and if these differences are explained by established crash risk factors. Methods We used data from a 2003/2004 Australian survey of young drivers, linked to police reported offence and crash data, hospital data and deaths data up to 2016. We used Poisson regression models adjusted for confounders to estimate the association between driving offences during 2003–2006 with car crash during 2007–2016. Results The study cohort comprised 20 781 young drivers of whom 7860 drivers (37.8%) had at least one driving offence and 2487 (12.0%) were involved in at least one crash. After adjusting for confounders in the regression model, drivers with three or more driving offences had 2.25 (95% CI 1.98 to 2.57), 2.87 (95% CI 1.60 to 5.17) and 3.28 (95% CI 2.28 to 4.72) times higher rates of any crash, crashes that resulted in hospital admission or death and single vehicle crashes compared with drivers with no driving offences. Conclusion Measures that successfully mitigate the underlying risk factors for both, crashes and offences, have the potential to improve road safety.
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Affiliation(s)
- Holger Möller
- School of Population Health, UNSW, Sydney, New South Wales, Australia .,Injury Division, The George Institute for Global Health, Newtown, New South Wales, Australia
| | - Patricia Cullen
- School of Population Health, UNSW, Sydney, New South Wales, Australia.,Injury Division, The George Institute for Global Health, Newtown, New South Wales, Australia.,Ngarruwan Ngadju, First Peoples Health and Wellbeing Research Centre, Australian Health Services Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
| | - Teresa Senserrick
- Centre for Accident Research and Road Safety - Queensland (CARRS-Q), Kelvin Grove, Queensland University of Technology (QUT), Brisbane, Queesnland, Australia
| | - Kris Rogers
- School of Population Health, UNSW, Sydney, New South Wales, Australia
| | - Soufiane Boufous
- School of Aviation, Transport and Road Safety (TARS) Research, Faculty of Science, UNSW, Sydney, New South Wales, Australia
| | - Rebecca Q Ivers
- School of Population Health, UNSW, Sydney, New South Wales, Australia.,Injury Division, The George Institute for Global Health, Newtown, New South Wales, Australia
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12
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A COMPARATIVE ANALYSIS OF ASSOCIATED INJURIES IN THE ELDERLY AND YOUTH FOR FACIAL FRACTURES. J Plast Reconstr Aesthet Surg 2022; 75:1979-1987. [DOI: 10.1016/j.bjps.2021.12.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 11/13/2021] [Accepted: 12/19/2021] [Indexed: 11/15/2022]
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13
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Tait R, Ivers R, Marino JL, Doherty D, Graham PL, Cunich M, Sanci L, Steinbeck K, Straker L, Skinner SR. Mental health and behavioural factors involved in road traffic crashes by young adults: analysis of the Raine Study. J Epidemiol Community Health 2021; 76:556-562. [PMID: 34965969 DOI: 10.1136/jech-2021-218039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 12/01/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND Road traffic crashes (RTC) are a leading cause of mortality and morbidity in young people. Severe mental health and behavioural conditions increase the likelihood of RTC, as do a range of driving-risk activities. METHOD We used data from the Raine Study, a prebirth cohort from Perth, Australia, to assess the relationship between measures of common mental health or behavioural conditions (Child Behavior Checklist Internalising and Externalising scores) at age 17 and subsequent RTC by 27 years, controlling for substance use and driving-risk activities. RESULTS By 27 years of age, of 937 participants, 386 (41.2%) reported zero crashes and 551 (58.8%) reported ≥1 crashes. In the baseline Poisson model, increased Externalising scores (eg, aggression and delinquency) were associated with increased RTC (incidence rate ratio (IRR)=1.02, 95% CI 1.01 to 1.02): increased Internalising scores (eg, anxiety and depression) were associated with fewer RTC (IRR=0.99, 95% CI 0.98 to 1.00). In the fully adjusted model, the mental health measures were not significant (Externalising IRR=1.01, 95% CI 0.99 to 1.02: Internalising IRR=0.99, 95% CI 0.99 to 1.00). Risky driver activities, such as falling asleep while driving (IRR=1.34), more frequent use of a hands-free telephone (IRR=1.35) and more frequent hostility towards other drivers (IRR=1.30) increased the rate of RTC. CONCLUSION Measures of mental health scores at age 17 were not predictive of subsequent RTC, after adjusting for measures of driving-risk activities. We need to better understand the determinants of externalising and risky driving behaviours if we are to address the increased risk of RTC.
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Affiliation(s)
- Robert Tait
- National Drug Research Institute, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Rebecca Ivers
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Jennifer L Marino
- Department of Obstetrics and Gynaecology, University of Melbourne & Royal Women's Hospital, Parkville, Victoria, Australia.,Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.,School of Population Health and Global Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - Dorota Doherty
- Division of Obstetrics and Gynaecology, Faculty of Medicine and Medical Sciences, The University of Western Australia, Perth, Western Australia, Australia.,Women and Infants Research Foundation, Subiaco, Western Australia, Australia
| | - Petra L Graham
- Centre for Economic Impacts of Genomic Medicine (GenIMPACT) and Department of Mathematics and Statistics, Macquarie University, Sydney, New South Wales, Australia
| | - Michelle Cunich
- Charles Perkins Centre, Faculty of Medicine and Health (Central Clinical School), University of Sydney, Sydney, New South Wales, Australia.,Sydney Institute for Women, Children and their Families, Sydney Local Health District, Camperdown, New South Wales, Australia.,The ANZAC Research Institute, Concord Repatriation General Hospital, Sydney Local Health District, Concord, New South Wales, Australia.,Sydney Health Economics Collaborative, Sydney Local Health District, Camperdown, New South Wales, Australia
| | - Lena Sanci
- Department of General Practice, University of Melbourne, Carlton, Victoria, Australia
| | - Katharine Steinbeck
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Leon Straker
- School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - S Rachel Skinner
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
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14
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Möller H, Ivers R, Cullen P, Rogers K, Boufous S, Patton G, Senserrick T. Risky youth to risky adults: Sustained increased risk of crash in the DRIVE study 13 years on. Prev Med 2021; 153:106786. [PMID: 34506819 DOI: 10.1016/j.ypmed.2021.106786] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 07/05/2021] [Accepted: 09/04/2021] [Indexed: 11/25/2022]
Abstract
The objective of this study was to investigate if drivers who exhibit risky driving behaviours during youth (aged 17-24 years) have an increased risk of car crash up to 13 years later. We used data from the DRIVE study, a 2003/04 survey of 20,806 young novice drivers in New South Wales, Australia. The data were linked with police crash, hospital and deaths data up to 2016. We analysed differences in crash associated with 13 items of risky driving behaviours using negative binominal regression models adjusted for driver demographics, driving exposure and known crash risk factors. The items were summarised in one index and grouped into quintiles for the analysis. After adjusting for confounding, drivers of the third (RR 1.16, 95% CI 1.05-1.30), fourth (RR1.22, 95% CI1.09-1.36) and fifth quintile (RR 1.36, 95% CI 1.21-1.53) had higher crash rates compared to the lowest risk-takers. Drivers with the highest scores on the risky driving measure had higher rates of crash related hospital admission or death (RR 1.92, 95% CI 1.13-3.27), crashes in wet conditions (RR 1.35,95% CI 1.05-1.73), crashes in darkness (RR 1.55, 95% CI 1.25-1.93) and head-on crashes (RR 2.14, 95% CI 1.07-4.28), compared with drivers with the lowest scores. Novice adolescent drivers who reported high levels of risky driving when they first obtained a driver licence remained at increased risk of crash well into adulthood. Measures that successfully reduce early risky driving, have the potential to substantially reduce road crashes and transport related injuries and deaths over the lifespan.
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Affiliation(s)
- Holger Möller
- School of Population Health, UNSW, Sydney, New South Wales, Australia; The George Institute for Global Health, Newtown, New South Wales, Australia
| | - Rebecca Ivers
- School of Population Health, UNSW, Sydney, New South Wales, Australia; The George Institute for Global Health, Newtown, New South Wales, Australia.
| | - Patricia Cullen
- School of Population Health, UNSW, Sydney, New South Wales, Australia; The George Institute for Global Health, Newtown, New South Wales, Australia; Ngarruwan Ngadju, First Peoples Health and Wellbeing Research Centre, Australian Health Services Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
| | - Kris Rogers
- The George Institute for Global Health, Newtown, New South Wales, Australia; University of Technology Sydney (UTS), Graduate School of Health, Sydney, New South Wales, Australia
| | - Soufiane Boufous
- School of Aviation, Transport and Road Safety (TARS) Research, Faculty of Science, UNSW, Sydney, New South Wales, Australia
| | - George Patton
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia; Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Victoria, Australia; Centre for Adolescent Health, The Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Teresa Senserrick
- Queensland University of Technology (QUT), Centre for Accident Research and Road Safety - Queensland (CARRS-Q), Kelvin Grove, Queensland, Australia
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15
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Pulido J, Molist G, Vallejo F, Jiménez-Mejías E, Hoyos J, Regidor E, Barrio G. No effect of the Penalty Point System on road traffic accident mortality among men with a high socioeconomic status in Spain. ACCIDENT; ANALYSIS AND PREVENTION 2021; 156:106154. [PMID: 33933718 DOI: 10.1016/j.aap.2021.106154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 04/15/2021] [Accepted: 04/17/2021] [Indexed: 06/12/2023]
Abstract
The purpose of this study was to assess the effect of the Penalty Point System (PPS) on road traffic accident mortality by gender and socioeconomic status. We conducted a nationwide prospective study covering adult people living in Spain on November 2001. They were followed up until 30 Nov 2007 to determine vital status and cause of death. An interrupted time-series analysis was used to assess whether PPS (explanatory variable) had both immediate and long-term effect on the rates of road traffic accident mortality (RTAMs) separately by gender. Subjects were classified by socioeconomic status (low and high) using two indicators: educational attainment (up to lower secondary education; upper secondary education or more) and occupation (manual and non-manual workers). We performed several segmented Poisson regression models, controlling for trend, seasonality, 2004 road safety measures and fuel consumption as proxy for traffic exposure. Among men, we found a decrease on the RTAMs immediately after PPS in those with low educational level (16.2 %, IC95 %: 6.1 %-25.2 %) and manual workers (16.3 %, IC95 %: 2.8 %-27.8 %), and a non-significant increase among those with high education level and non-manual workers (6.2 % and 1.8 %). Among women, there were no significant differences in the immediate effect of PPS by socioeconomic status. We did not identify significant trend changes between pre-PPS and post-PPS periods in any socioeconomic group. In a context of downward trend of traffic mortality, the PPS implementation led to an immediate reduction on death rates only among men with a low socioeconomic status.
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Affiliation(s)
- J Pulido
- Department of Public Health and Maternal and Child Health, Complutense University of Madrid, Madrid, Spain; National School of Public Health, Institute of Health Carlos III, Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - G Molist
- Granollers General Hospital, Research and Innovation Area, Granollers, Barcelona, Spain
| | - F Vallejo
- National School of Public Health, Institute of Health Carlos III, Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - E Jiménez-Mejías
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain; Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain; Biosanitary Research Institute (Ibs Granada), Granada, Spain
| | - J Hoyos
- Department of Public Health and Maternal and Child Health, Complutense University of Madrid, Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.
| | - E Regidor
- Department of Public Health and Maternal and Child Health, Complutense University of Madrid, Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain; Health Research Institute of the Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - G Barrio
- National School of Public Health, Institute of Health Carlos III, Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
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Stenehjem JS, Røise O, Nordseth T, Clausen T, Natvig B, O Skurtveit S, Eken T, Kristiansen T, Gran JM, Rosseland LA. Injury Prevention and long-term Outcomes following Trauma-the IPOT project: a protocol for prospective nationwide registry-based studies in Norway. BMJ Open 2021; 11:e046954. [PMID: 34006552 PMCID: PMC8137183 DOI: 10.1136/bmjopen-2020-046954] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Traumatic injuries constitute a major cause of mortality and morbidity. Still, the public health burden of trauma in Norway has not been characterised using nationwide registry data. More knowledge is warranted on trauma risk factors and the long-term outcomes following trauma. The Injury Prevention and long-term Outcomes following Trauma project will establish a comprehensive research database. The Norwegian National Trauma Registry (NTR) will be merged with several data sources to pursue the following three main research topics: (1) the public health burden of trauma to society (eg, excess mortality and disability-adjusted life-years (DALYs)), (2) trauma aetiology (eg, socioeconomic factors, comorbidity and drug use) and (3) trauma survivorship (eg, survival, drug use, use of welfare benefits, work ability, education and income). METHODS AND ANALYSIS The NTR (n≈27 000 trauma patients, 2015-2018) will be coupled with the data from Statistics Norway, the Norwegian Patient Registry, the Cause of Death Registry, the Registry of Primary Health Care and the Norwegian Prescription Database. To quantify the public health burden, DALYs will be calculated from the NTR. To address trauma aetiology, we will conduct nested case-control studies with 10 trauma-free controls (drawn from the National Population Register) matched to each trauma case on birth year, sex and index date. Conditional logistic regression models will be used to estimate trauma risk according to relevant exposures. To address trauma survivorship, we will use cohort and matched cohort designs and time-to-event analyses to examine various post-trauma outcomes. ETHICS AND DISSEMINATION The project is approved by the Regional Committee for Medical Research Ethics. The project's data protection impact assessment is approved by the data protection officer. Results will be disseminated to patients, in peer-reviewed journals, at conferences and in the media.
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Affiliation(s)
- Jo Steinson Stenehjem
- Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
- Department of Biostatistics, Oslo Centre for Biostatistics and Epidemiology, University of Oslo, Oslo, Norway
- Department of Research, Cancer Registry of Norway, Oslo, Norway
| | - Olav Røise
- The Norwegian National Trauma Registry, Division of Orthopedic Surgery, Oslo University Hospital, Oslo, Norway
- Faculty of Health Sciences, SHARE - Centre for Resilience in Healthcare, University of Stavanger, Stavanger, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Trond Nordseth
- Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Anesthesia and Intensive Care Medicine, St.Olav Hospital, Trondheim, Norway
| | - Thomas Clausen
- Norwegian Centre for Addiction Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Bård Natvig
- Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Svetlana O Skurtveit
- Norwegian Centre for Addiction Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Mental Disorders, Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Torsten Eken
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Anesthesiology, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
| | - Thomas Kristiansen
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Anesthesiology, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
| | - Jon Michael Gran
- Department of Biostatistics, Oslo Centre for Biostatistics and Epidemiology, University of Oslo, Oslo, Norway
| | - Leiv Arne Rosseland
- Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
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17
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Mőller H, Rogers K, Cullen P, Senserrick T, Boufous S, Ivers R. Socioeconomic status during youth and risk of car crash during adulthood. Findings from the DRIVE cohort study. J Epidemiol Community Health 2021; 75:755-763. [PMID: 33687994 DOI: 10.1136/jech-2020-214083] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 11/16/2020] [Accepted: 12/20/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND Young drivers of low socioeconomic status (SES) have a disproportionally high risk of crashing compared with their more affluent counterparts. Little is known if this risk persists into adulthood and if it differs between men and women. METHODS We used data from a 2003/2004 Australian survey of young drivers (n=20 806), which included measures of drivers' demographics and established crash risk factors. These data were linked to police-reported crash, hospital and death data up to 2016. We used negative binomial regression models to estimate the association between participants' SES, with car crash. RESULTS After adjusting for confounding, drivers of lowest SES had 1.30 (95% CI 1.20 to 1.42), 1.90 (95% CI 1.25 to 2.88), 3.09 (95% CI 2.41 to 3.95) and 2.28 (95% CI 1.85 to 2.82) times higher rate of crash, crash-related hospitalisation, crash in country areas and crash on streets with a speed limit of 80 km/hour or above compared with drivers of highest SES, respectively. For single-vehicle crashes, women in the lowest SES groups had 2.88 (95% CI 1.83 to 4.54) times higher rate of crash compared with those in the highest SES group, but no differences were observed for men from different SES groups. CONCLUSION Young drivers who lived in areas of low SES at the time of the survey had a sustained increased risk of crash over the following 13 years compared with drivers from the most affluent areas. Our findings suggest that in addition to traditional measures, road transport injury prevention needs to consider the wider social determinants of health.
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Affiliation(s)
- Holger Mőller
- Injury Division, The George Institute for Global Health, Newtown, New South Wales, Australia .,School of Population Health, UNSW, Sydney, New South Wales, Australia
| | - Kris Rogers
- Injury Division, The George Institute for Global Health, Newtown, New South Wales, Australia.,Graduate School of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Patricia Cullen
- School of Population Health, UNSW, Sydney, New South Wales, Australia.,Ngarruwan Ngadju, First Peoples Health and Wellbeing Research Centre, Australian Health Services Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
| | - Teresa Senserrick
- Queensland University of Technology (QUT), Centre for Accident Research and Road Safety - Queensland (CARRS-Q), Kelvin Grove, Brisbane, Queensland, Australia
| | - Soufiane Boufous
- School of Aviation, Transport and Road Safety (TARS) Research,Faculty of Science, UNSW, Sydney, New South Wales, Australia
| | - Rebecca Ivers
- School of Population Health, UNSW, Sydney, New South Wales, Australia
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18
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Vaca FE, Li K, Tewahade S, Fell JC, Haynie D, Simons-Morton B, Romano E. Factors Contributing to Delay in Driving Licensure Among U.S. High School Students and Young Adults. J Adolesc Health 2021; 68:191-198. [PMID: 32646830 PMCID: PMC8136290 DOI: 10.1016/j.jadohealth.2020.05.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 04/28/2020] [Accepted: 05/01/2020] [Indexed: 11/24/2022]
Abstract
PURPOSE More teens delay in driving licensure (DDL). It is conceivable they miss Graduated Driver Licensing (GDL) safety benefits. We assessed prevalence, disparities, and factors associated with DDL among emerging adults. METHODS Data used were from all seven waves (W1-7) of the NEXT Generation Health Study (W1 in 10th grade [2009-2010]). The outcome variable was DDL (long-DDL [delayed >2 years], intermediate-DDL [delayed 1-2 years] versus no-DDL), defined as participants receiving driver licensure ≥1 year after initial eligibility. Independent variables included sex, urbanicity, race/ethnicity, family structure, parental education, family affluence, parental monitoring knowledge, parent perceived importance of alcohol nonuse, and social media use. Logistic regressions were conducted. RESULTS Of 2,525 participants eligible for licensure, 887 (38.9%) reported intermediate-DDL and 1,078 (30.1%) long-DDL. Latinos (adjusted odds ratio [AOR] = 2.5 vs. whites) and those with lower affluence (AOR = 2.5 vs. high) had higher odds of intermediate-DDL. Latinos (AOR = 4.5 vs. whites), blacks (AOR = 2.3 vs. whites), those with single parent (AOR = 1.7 vs. both biological parents), whose parents' education was high school or less (AOR = 3.7 vs. bachelor+) and some college (AOR = 2.0 vs. bachelor+) levels, and those with lower affluence (AOR = 4.4 vs. high) had higher odds of long-DDL. Higher mother's monitoring knowledge (AOR = .6) was associated with lower odds of long-DDL, but not intermediate-DDL. CONCLUSIONS Some teens that DDL "age out" of protections afforded to them by GDL driver restrictions. Minority race/ethnicity, socioeconomic status, urbanicity, and parenting factors contribute to DDL. Further study of these factors and their individual/collective contributions to DDL is needed to understand potential unintended consequences of GDL, particularly in more vulnerable youth.
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Affiliation(s)
- Federico E. Vaca
- Department of Emergency Medicine, Developmental
Neurocognitive Driving Simulation Research Center (DrivSim Lab), Yale University
School of Medicine
| | - Kaigang Li
- Department of Emergency Medicine, Developmental Neurocognitive Driving Simulation Research Center (DrivSim Lab), Yale University School of Medicine; Department of Health and Exercise Science, Colorado State University, Fort Collins, Colorado; Department of Community and Behavioral Health, Colorado School of Public Health, Fort Collins, Colorado.
| | | | | | - Denise Haynie
- Virginia Tech Transportation Institute, Blacksburg,
Virginia
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Kita E, Luria G. Differences between males and females in the prediction of smartphone use while driving: Mindfulness and income. ACCIDENT; ANALYSIS AND PREVENTION 2020; 140:105514. [PMID: 32244090 DOI: 10.1016/j.aap.2020.105514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 03/16/2020] [Accepted: 03/16/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION This study examines the relationship between two variables-mindfulness and income-with regards to their relationship to the use of smartphones by young drivers, which has been known to increase the likelihood of car accidents, endangering young drivers and other road users. The study focuses on the relationship between these variables and the use of smartphones while driving, and how this relationship differs between males and females. METHOD The study sample included 221 young drivers who were legally permitted to drive without supervision. The subjects were first asked to complete questionnaires on mindfulness and income. Next, their smartphone use while driving was monitored over a one-month period. This study is unique as it used an objective smartphone monitoring application (rather than self-reporting) to count the number of times the young participants actually touched their smartphones while driving. RESULTS The findings show that the effects of social and personal factors (i.e., income and mindfulness) on the use of smartphones while driving are significant for males but not for females. CONCLUSIONS Most studies that investigate differences between males and females with respect to safety focus on differences in the averages of safety-related variables (such as safety performance and outcomes). In the current study, however, we identified differences in relationships between variables and demonstrated that what predicts safety-related behavior in males may not be a good predictor for females. PRACTICAL APPLICATIONS Mindfulness and income can be used to identify male populations that are at risk of using smartphones while driving. Interventions that improve mindfulness can be used to reduce the use of smartphones by male drivers.
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Affiliation(s)
- Erez Kita
- Faculty of Welfare and Health Sciences, Department of Human Services, University of Haifa, Mount Carmel, Haifa 31905, Israel; Or Yarok - The Association for Safer Driving in Israel, Israel.
| | - Gil Luria
- Faculty of Welfare and Health Sciences, Department of Human Services, University of Haifa, Mount Carmel, Haifa 31905, Israel.
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20
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An Assessment of Age and Gender Characteristics of Mixed Traffic with Autonomous and Manual Vehicles: A Cellular Automata Approach. SUSTAINABILITY 2020. [DOI: 10.3390/su12072922] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Traffic congestion has become increasingly prevalent in many urban areas, and researchers are continuously looking into new ways to resolve this pertinent issue. Autonomous vehicles are one of the technologies expected to revolutionize transportation systems. To this very day, there are limited studies focused on the impact of autonomous vehicles in heterogeneous traffic flow in terms of different driving modes (manual and self-driving). Autonomous vehicles in the near future will be running parallel with manual vehicles, and drivers will have different characteristics and attributes. Previous studies that have focused on the impact of autonomous vehicles in these conditions are scarce. This paper proposes a new cellular automata model to address this issue, where different autonomous vehicles (cars and buses) and manual vehicles (cars and buses) are compared in terms of fundamental traffic parameters. Manual cars are further divided into subcategories on the basis of age groups and gender. Each category has its own distinct attributes, which make it different from the others. This is done in order to obtain a simulation as close as possible to a real-world scenario. Furthermore, different lane-changing behavior patterns have been modeled for autonomous and manual vehicles. Subsequently, different scenarios with different compositions are simulated to investigate the impact of autonomous vehicles on traffic flow in heterogeneous conditions. The results suggest that autonomous vehicles can raise the flow rate of any network considerably despite the running heterogeneous traffic flow.
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21
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Heathcote K, Wullschleger M, Gardiner B, Morgan G, Barbagello H, Sun J. The Importance of Place of Residence on Hospitalized Outcomes for Severely Injured Trauma Patients: A Trauma Registry Analysis. J Rural Health 2019; 36:381-393. [PMID: 31840316 DOI: 10.1111/jrh.12407] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
PURPOSE Socioecological factors are understudied in relation to trauma patients' outcomes. This study investigated the association of neighborhood socioeconomic disadvantage (SED) and remoteness of residence on acute length of hospital stay days (ALSD) and inpatient mortality. METHODS A retrospective cohort study was conducted on adults hospitalized for major trauma in a Level 1 trauma center in southeast Queensland from 2014 to 2017. Neighborhood SED and remoteness indices were linked to individual patient variables. Step-wise multivariable negative binomial regression and proportional hazards regression analyses were undertaken, adjusting for injury and patient factors. Outcomes were ALSD and inpatient mortality. FINDINGS We analyzed 1,025 patients. Statistically significant increased hazard of inpatient mortality was found for older age (HR 3.53, 95% CI: 1.77-7.11), injury severity (HR 5.27, 95% CI: 2.78-10.02), remoteness of injury location (HR 1.75, 95% CI: 1.06-2.09), and mechanisms related to intentional self-harm or assault (HR 2.72, 95% CI: 1.48-5.03,). Excess mortality risk was apparent for rural patients sustaining less severe injuries (HR 4.20, 95% CI: 1.35-13.10). Increased risk for longer ALSD was evident for older age (RR 1.35, 95% CI: 1.07-1.71), head injury (RR 1.39, 95% CI: 1.19-1.62), extremity injuries (RR 1.82, 95% CI: 1.55-2.14), and higher injury severity scores (ISS) (RR 1.51, 95%: CI: 1.29-1.76). CONCLUSIONS Severely injured rural trauma patients are more likely to be socioeconomically disadvantaged and sustain injuries predisposing them to worse hospital outcomes. Further research is needed to understand more about care pathways and factors influencing the severity, mechanism and clinical consequences of rural-based traumatic injuries.
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Affiliation(s)
| | - Martin Wullschleger
- Division of Specialty and Procedural Services, Gold Coast University Hospital and School of Medicine, Griffith University, Parkland, Gold Coast, Queensland, Australia
| | - Ben Gardiner
- Division of Specialty and Procedural Services, Gold Coast University Hospital and School of Medicine, Griffith University, Parkland, Gold Coast, Queensland, Australia
| | - Geoffrey Morgan
- School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Holly Barbagello
- School of Medicine, Griffith University, Gold Coast, Queensland, Australia
| | - Jing Sun
- School of Medicine, Griffith University, Gold Coast, Queensland, Australia
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Keeves J, Ekegren CL, Beck B, Gabbe BJ. The relationship between geographic location and outcomes following injury: A scoping review. Injury 2019; 50:1826-1838. [PMID: 31353092 DOI: 10.1016/j.injury.2019.07.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 07/02/2019] [Accepted: 07/08/2019] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Globally, injury incidence and injury-fatality rates are higher in regional and remote areas. Recovery following serious injury is complex and requires a multi-disciplinary approach to management and community re-integration to optimise outcomes. A significant knowledge gap exists in understanding the regional variations in hospital and post-discharge outcomes following serious injury. The aim of this study was to review the evidence exploring the association between the geographic location, including both location of the event and place of residence, and outcomes following injury. MATERIALS AND METHODS A scoping review was used to investigate this topic and provide insight into geographic variation in outcomes following traumatic injury. Seven electronic databases and reference lists of relevant articles were searched from inception to October 2018. Studies were included if they measured injury-related mortality, outcomes associated with hospital admission, post-injury physical or psychological function and analysed these outcomes in relation to geographic location. RESULTS Of the 2,213 studies identified, 47 studies were included revealing three key groups of outcomes: mortality (n = 35), other in-hospital outcomes (n = 8); and recovery-focused outcomes (n = 12). A variety of measures were used to classify rurality across studies with inconsistent definitions of rurality/remoteness. Of the studies reporting injury-related mortality, findings suggest that there is a greater risk of fatality in rural areas overall and in the pre-hospital phase. For those patients that survived to hospital, the majority of studies included identified no difference in mortality between rural and urban patient groups. In the small number of studies that reported other in-hospital and recovery outcomes no consistent trends were identified. CONCLUSION Rural patients had a higher overall and pre-hospital mortality following injury. However, once admitted to hospital, there was no significant difference in mortality. Inconsistencies were noted across measures of rurality measures highlighting the need for more specific and consistent international classification methods. Given the paucity of data on the impact of geography on non-mortality outcomes, there is a clear need to develop a larger evidence base on regional variation in recovery following injury to inform the optimisation of post-discharge care services.
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Affiliation(s)
- Jemma Keeves
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia; Physiotherapy Department, Epworth Hospital, Melbourne, Australia.
| | - Christina L Ekegren
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Ben Beck
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Belinda J Gabbe
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
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Downey LT, Saleh W, Muley D, Kharbeche M. Pedestrian crashes at priority-controlled junctions, roundabouts, and signalized junctions: The UK case study. TRAFFIC INJURY PREVENTION 2019; 20:308-313. [PMID: 30971142 DOI: 10.1080/15389588.2019.1574972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 01/16/2019] [Accepted: 01/17/2019] [Indexed: 06/09/2023]
Abstract
Objectives: Over half of pedestrians killed and seriously injured in Great Britain in 2015 were involved in crashes at junctions. This study investigates the nature of these crashes. Methods: A study was conducted into pedestrian casualty crashes at priority controlled junctions, roundabouts and signalised junctions in England between 2005 and 2015 using information from the UK STATS19 accident database, the UK National Travel Survey and the UK National Census. Consideration was given to coding frequencies of contributory factors, exposure (in terms of miles walked or driven) as well as age, gender and the resident deprivation index of the road users involved. Results and Conclusions: In terms of indicative blame, the coding frequencies of subjectively determined pedestrian actions and behaviour factors which might have contributed to pedestrian casualty crashes were found to be between 1.6 and 2.8 times the frequencies of driver actions and behavioural factors. Substantial social gradients were found in pedestrian casualty rates per miles walked and in the driver involvement rates per mile driven with those from the most deprived quintile having higher rates. In addition, it was found that female pedestrians, aged 60 years and over, had higher pedestrian casualty rates, per billion miles walked, for all three junction types, when compared with males and females under the age of 60 years, apart from male pedestrians aged 16 years and younger at priority controlled junctions.
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Affiliation(s)
- Lucy Tamsin Downey
- a School of Engineering and the Built Environment , Edinburgh Napier University , Edinburgh , UK
| | - Wafaa Saleh
- b Transport Research Institute , Edinburgh Napier University , Edinburgh , UK
| | - Deepti Muley
- c Qatar Transportation and Traffic Safety Studies Centre , Qatar University , Doha , Qatar
| | - Mohamed Kharbeche
- c Qatar Transportation and Traffic Safety Studies Centre , Qatar University , Doha , Qatar
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24
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Rewarding safe choices in peer contexts: Adolescent brain activity during decision making. Biol Psychol 2019; 142:45-53. [DOI: 10.1016/j.biopsycho.2019.01.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 12/14/2018] [Accepted: 01/14/2019] [Indexed: 11/19/2022]
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25
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Brunello LFS, Bettega AL, Reis PGTDA, Tomasich FDS, Collaço IA, Guetter CR, Rezende TMDS, Nasr A. Influence of trauma origin site on admission rates of patients submitted to emergency laparotomy. ACTA ACUST UNITED AC 2018; 45:e1970. [PMID: 30379215 DOI: 10.1590/0100-6991e-20181970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2018] [Accepted: 09/09/2018] [Indexed: 11/22/2022]
Abstract
OBJECTIVE to evaluate the influence of the site of trauma occurrence on the trauma scores of patients submitted to emergency laparotomy. METHODS this is a retrospective, observational, analytical study. We included 212 patients who underwent exploratory laparotomies in the period of January 2015 and December 2017. We obtained information about the accident site and vital data of the patients based on data collection through electronic and physical records. We analyzed the trauma indices of patients from Curitiba and its Metropolitan Region and the place where the patient was rescued (physical establishment or public road). RESULTS among the 212 patients studied, 184 (86.7%) were brought by the Prehospital Care Service from the city of Curitiba, and 28 (13.3%), from the Metropolitan Region of Curitiba. Twenty-five patients (17.6%) were rescued in physical establishments, while 117 (82.4%) were rescued on public roads. We observed higher values of Injurity Severity Scores (ISS) in patients coming from the Metropolitan Region than in those coming from Curitiba (29.78 vs 22.46, P=0.009), but higher values of Trauma and Injury Severity Scores (TRISS) in patients from Curitiba than the ones from the Metropolitan Region (90.62 vs 81.30, P=0.015). Patients rescued in public roads presented lower Revised Trauma Scores (RTS) (6.96 vs 7.65, P=0.024) and TRISS (86.42 vs 97.21; P=0.012). CONCLUSION trauma victims from sites more distant from the referral center and rescued on public roads presented worse prognosis.
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Affiliation(s)
| | - Ana Luísa Bettega
- Hospital do Trabalhador, Serviço de Cirurgia Geral, Curitiba, PR, Brasil
| | | | | | | | | | | | - Adonis Nasr
- Hospital do Trabalhador, Serviço de Cirurgia Geral, Curitiba, PR, Brasil
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26
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Klaitman SS, Solomonov E, Yaloz A, Biswas S. The Incidence of Road Traffic Crashes Among Young People Aged 15-20 Years: Differences in Behavior, Lifestyle and Sociodemographic Indices in the Galilee and the Golan. Front Public Health 2018; 6:202. [PMID: 30094228 PMCID: PMC6071510 DOI: 10.3389/fpubh.2018.00202] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 07/02/2018] [Indexed: 11/13/2022] Open
Abstract
Background: Adolescent injuries and fatalities constitute a world health concern and present a major public health burden. Of all childhood injuries in Israel 61.8% occur during road traffic crashes. The risk of being injured or killed in a road traffic crash is especially high among individuals deemed to have a low socio-economic status, but, there also exist crucial risk factors for road traffic crashes that are intrinsic social determinants of health, including behavior, lifestyle, education and employment. These associations are explored in this study. Aim: To examine the contribution of socioeconomic inequalities to the incidence of road traffic crashes among adolescents living in the Galilee and the Golan. Methods: A large retrospective study of trauma records (N = 3293) of 15-20-year-old patients who were injured in road traffic crashes and admitted to Ziv Medical Center between 2004 and 2015 was performed. These patients were subcategorized according to their home address. Using census data and other databases associations between socioeconomic inequalities, intrinsic social determinants and the prevalence of road crashes were investigated. Results: Road traffic crashes in the Galilee and the Golan are more frequent among residents of low socioeconomic areas. Fifty-five percent of drivers are from the areas of lowest socioeconomic level (levels 2 to 4) and are responsible for 60% of the road traffic injuries admitted to Ziv Medical Center (p < 0.001). In contrast, 42% of drivers are from areas of medium socioeconomic level (levels 5 and 6) but are responsible for only 35% of road traffic injuries (p < 0.001). Young women in the Galilee and the Golan are less likely to be involved in road traffic crashes-35.8% compared to 64.2% in young men. Conclusions: This research has shown that youth, male gender, socioeconomic status, education level and the quality of road infrastructure are important factors in the incidence of road traffic crashes in the Galilee and the Golan. This should be taken into consideration by policy makers in order to develop appropriate interventions in road safety targeted at multiple levels.
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Affiliation(s)
- Shai S. Klaitman
- Department of Surgery, Ziv Medical Center, Bar Ilan Medical School in Safed, Safed, Israel
| | | | - Amir Yaloz
- Upper Galilee and Golan Heights, National Road Safety Authority, Jerusalem, Israel
| | - Seema Biswas
- Department of Surgery, Ziv Medical Center, Safed, Israel
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Adanu EK, Smith R, Powell L, Jones S. Multilevel analysis of the role of human factors in regional disparities in crash outcomes. ACCIDENT; ANALYSIS AND PREVENTION 2017; 109:10-17. [PMID: 28992450 DOI: 10.1016/j.aap.2017.09.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 08/02/2017] [Accepted: 09/26/2017] [Indexed: 06/07/2023]
Abstract
A growing body of research has examined the disparities in road traffic safety among population groups and geographic regions. These studies reveal disparities in crash outcomes between people and regions with different socioeconomic characteristics. A critical aspect of the road traffic crash epidemic that has received limited attention is the influence of local characteristics on human elements that increase the risk of getting into a crash. This paper applies multilevel logistic regression modeling techniques to investigate the influence of driver residential factors on driver behaviors in an attempt to explain the area-based differences in the severity of road crashes across the State of Alabama. Specifically, the paper reports the effects of characteristics attributable to drivers and the geographic regions they reside on the likelihood of a crash resulting in serious injuries. Model estimation revealed that driver residence (postal code or region) accounted for about 7.3% of the variability in the probability of a driver getting into a serious injury crash, regardless of driver characteristics. The results also reveal disparities in serious injury crash rate as well as significant proportions of serious injury crashes involving no seatbelt usage, driving under influence (DUI), unemployed drivers, young drivers, distracted driving, and African American drivers among some regions. The average credit scores, average commute times, and populations of driver postal codes are shown to be significant predictors for risk of severe injury crashes. This approach to traffic crash analysis presented can serve as the foundation for evidence-based policies and also guide the implementation of targeted countermeasures.
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Affiliation(s)
- Emmanuel Kofi Adanu
- Department of Civil, Construction and Environmental Engineering, The University of Alabama Tuscaloosa, AL, United States.
| | - Randy Smith
- Department of Computer Science, The University of Alabama Tuscaloosa, AL, United States.
| | - Lars Powell
- Alabama Center for Insurance Information and Research, The University of Alabama Tuscaloosa, AL, United States.
| | - Steven Jones
- Department of Civil, Construction and Environmental Engineering, The University of Alabama Tuscaloosa, AL, United States.
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28
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Shults RA, Banerjee T, Perry T. Who's not driving among U.S. high school seniors: A closer look at race/ethnicity, socioeconomic factors, and driving status. TRAFFIC INJURY PREVENTION 2016; 17:803-809. [PMID: 27064697 PMCID: PMC5712435 DOI: 10.1080/15389588.2016.1161761] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 03/01/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVES We examined associations among race/ethnicity, socioeconomic factors, and driving status in a nationally representative sample of >26,000 U.S. high school seniors. METHODS Weighted data from the 2012 and 2013 Monitoring the Future surveys were combined and analyzed. We imputed missing values using fully conditional specification multiple imputation methods. Multivariate logistic regression modeling was conducted to explore associations among race/ethnicity, socioeconomic factors, and driving status, while accounting for selected student behaviors and location. Lastly, odds ratios were converted to prevalence ratios. RESULTS 23% of high school seniors did not drive during an average week; 14% of white students were nondrivers compared to 40% of black students. Multivariate analysis revealed that minority students were 1.8 to 2.5 times more likely to be nondrivers than their white counterparts, and students who had no earned income were 2.8 times more likely to be nondrivers than those earning an average of ≥$36 a week. Driving status also varied considerably by student academic performance, number of parents in the household, parental education, census region, and urbanicity. CONCLUSIONS Our findings suggest that resources-both financial and time-influence when or whether a teen will learn to drive. Many young people from minority or lower socioeconomic families who learn to drive may be doing so after their 18th birthday and therefore would not take advantage of the safety benefits provided by graduated driver licensing. Innovative approaches may be needed to improve safety for these young novice drivers.
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Affiliation(s)
- Ruth A. Shults
- Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control, Atlanta, Georgia
| | - Tanima Banerjee
- Office of Research and Global Affairs, University of Michigan School of Nursing, Ann Arbor, Michigan
| | - Timothy Perry
- University of Michigan Institute for Social Research, Ann Arbor, Michigan
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29
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Corfield AR, MacKay DF, Pell JP. Association between trauma and socioeconomic deprivation: a registry-based, Scotland-wide retrospective cohort study of 9,238 patients. Scand J Trauma Resusc Emerg Med 2016; 24:90. [PMID: 27388437 PMCID: PMC4937548 DOI: 10.1186/s13049-016-0275-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Accepted: 06/09/2016] [Indexed: 02/03/2023] Open
Abstract
Background Trauma remains a leading cause of morbidity and mortality in the UK and throughout the world. Socioeconomic deprivation has been linked with many types of ill-health and previous studies have shown an association with injury in other parts of the world. The aim of this study was to investigate the association between socioeconomic deprivation and trauma incidence and case-fatality in Scotland. Methods The study included nine thousand two hundred and thirty eight patients attending Emergency Departments following trauma across Scotland in 2011-12. A retrospective cohort study was conducted using secondary data extracted from the national trauma registry. Postcode of residence was used to generate deciles using the Scottish Index of Multiple Deprivation. The incidence rate ratio (IRR) was calculated to allow comparison of incidence of trauma across SIMD deciles. For mortality, observed: expected ratios were obtained using observed mortality in the cohort and expected deaths using probability of survival based on Trauma and Injury Severity Score (TRISS) method. Results Compared with the most deprived decile, the least deprived had an incidence rate ratio (IRR) for all trauma of 0.43 (95 % CI 0.32–0.58, p < 0.001). The association was stronger for penetrating trauma (IRR 0.07, 95 % CI .01–0.56, p = 0.011). There was a significant interaction between age, gender and SIMD. For case fatality, multivariate logistic regression showed that, severity of trauma (ISS > 15) OR 18.11 (95 % CI 13.91 to 23.58) and type of injury (Penetrating versus blunt injury) OR 2.07 (95 % CI 1.15 to 3.72) remain as independent predictors of case fatality in this dataset. Discussion Our data shows a higher incidence of trauma amongst a socioeconomically deprived population, in keeping with other areas of the world. In our dataset, outcome, as measured by in-hospital mortality, does not appear to be associated with socioeconomic deprivation. Conclusion In Scotland, populations living in socioeconomically deprived areas have a higher incidence of trauma, especially penetrating trauma, requiring hospital attendance. Case fatality is associated with more severe trauma and penetrating trauma, but not socioeconomic deprivation. Electronic supplementary material The online version of this article (doi:10.1186/s13049-016-0275-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Danny F MacKay
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, G12 8RZ, UK
| | - Jill P Pell
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, G12 8RZ, UK
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Palmera-Suárez R, López-Cuadrado T, Brockhaus S, Fernández-Cuenca R, Alcalde-Cabero E, Galán I. Severity of disability related to road traffic crashes in the Spanish adult population. ACCIDENT; ANALYSIS AND PREVENTION 2016; 91:36-42. [PMID: 26950034 DOI: 10.1016/j.aap.2016.02.024] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Revised: 12/14/2015] [Accepted: 02/26/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND The severity of disability related to road traffic crashes has been little studied, despite the significant health and socio-economic impacts that determine victims' quality of life. OBJECTIVE To estimate the consequences of road traffic crashes on the severity of disability, in terms of individuals' capacity to execute activities and perform tasks in their current environment, using aids. METHODS Cross-sectional study conducted on community-dwelling participants in the "2008 National Survey of Disability", with data on 91,846 households having 20,425 disabled persons, 443 of whom had disability due to road traffic crashes. We measured severity using two indicators, i.e., the Capacity (CSI) and Performance (PSI) Severity Indices. RESULTS The highest proportion of disability was mild (CSI=70.5%; PSI=80.8%), while 7.6% (CSI) and 4.9% (PSI) was severe/complete respectively. The moderate/severe disability rate was 0.6 per thousand on the CSI, decreasing to 0.4 per thousand on the PSI. No differences were observed by age or sex. Moderate/severely disabled persons had a fourfold higher probability of being retired or unfit for work. Mental and nervous system impairments were more closely related to moderate/severe/complete problems of capacity and performance (p<0.001), disability for carrying out general tasks and demands, and interpersonal interactions and relationships (p<0.001). Being permanently bedridden (p<0.001), receiving aids (p<0.001), family support (p<0.05) and moving home (p<0.05) increased with an increase in the level of severity. CONCLUSION Road traffic crashes mainly cause mild disability. Moderate/severe disability is associated with lower work capacity, greater functional dependence, and increased need of aids, moving home and family support.
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Affiliation(s)
- Rocío Palmera-Suárez
- Department of Epidemiological Analysis and Health Situation, National Centre for Epidemiology, Carlos III Institute of Health, Calle Monforte de Lemos 5, Pabellón 12, PC 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), National Centre for Epidemiology, Carlos III Institute of Health, Calle Monforte de Lemos 5, Pabellón 12, PC 28029 Madrid, Spain.
| | - Teresa López-Cuadrado
- Department of Epidemiological Analysis and Health Situation, National Centre for Epidemiology, Carlos III Institute of Health, Calle Monforte de Lemos 5, Pabellón 12, PC 28029 Madrid, Spain; Department of Preventive Medicine and Public Health. School of Medicine, Autonomous University of Madrid/IdiPAZ (Instituto de Investigación del Hospital Universitario La Paz/La Paz University Teaching Hospital Research Institute), Calle del Arzobispo Morcillo 4, PC 28029 Madrid, Spain.
| | - Sarah Brockhaus
- Department of Statistics, Ludwig-Maximilians-Universität, Ludwigstraße 33, PC 80539 Munich, Germany.
| | - Rafael Fernández-Cuenca
- Department of Epidemiological Analysis and Health Situation, National Centre for Epidemiology, Carlos III Institute of Health, Calle Monforte de Lemos 5, Pabellón 12, PC 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), National Centre for Epidemiology, Carlos III Institute of Health, Calle Monforte de Lemos 5, Pabellón 12, PC 28029 Madrid, Spain.
| | - Enrique Alcalde-Cabero
- Department of Applied Epidemiology, National Centre for Epidemiology, Carlos III Institute of Health, Calle Monforte de Lemos 5, Pabellón 12, PC 28029 Madrid, Spain.
| | - Iñaki Galán
- Department of Applied Epidemiology, National Centre for Epidemiology, Carlos III Institute of Health, Calle Monforte de Lemos 5, Pabellón 12, PC 28029 Madrid, Spain; Department of Preventive Medicine and Public Health. School of Medicine, Autonomous University of Madrid/IdiPAZ (Instituto de Investigación del Hospital Universitario La Paz/La Paz University Teaching Hospital Research Institute), Calle del Arzobispo Morcillo 4, PC 28029 Madrid, Spain.
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Harper S, Charters TJ, Strumpf EC. Trends in Socioeconomic Inequalities in Motor Vehicle Accident Deaths in the United States, 1995-2010. Am J Epidemiol 2015; 182:606-14. [PMID: 26354899 DOI: 10.1093/aje/kwv099] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Accepted: 04/07/2015] [Indexed: 11/12/2022] Open
Abstract
Motor vehicle accident (MVA) mortality has been declining overall, but little is known about trends by socioeconomic position. We examined trends in education-related inequalities in US MVA death rates from 1995 to 2010. We used mortality data from the National Center for Health Statistics and population estimates from the Current Population Survey, and we calculated vehicle- and person-miles traveled using data from the National Household Travel Survey. We used negative binomial regression to estimate crude and age-, sex-, and race-adjusted mortality rates among adults aged 25 years or more. We found larger mortality decreases among the more highly educated and some evidence of mortality increases among the least educated. Adjusted death rates were 15.3 per 100,000 population (95% confidence interval (CI): 10.7, 19.9) higher at the bottom of the education distribution than at the top of the education distribution in 1995, increasing to 17.9 per 100,000 population (95% CI: 14.8, 21.0) by 2010. In relative terms, adjusted death rates were 2.4 (95% CI: 1.7, 3.0) times higher at the bottom of the education distribution than at the top in 1995, increasing to 4.3 times higher (95% CI: 3.4, 5.3) by 2010. Inequality increases were larger in terms of vehicle-miles traveled. Although overall MVA death rates declined during this period, socioeconomic differences in MVA mortality have persisted or worsened over time.
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Palmera-Suárez R, López-Cuadrado T, Almazán-Isla J, Fernández-Cuenca R, Alcalde-Cabero E, Galán I. Disability related to road traffic crashes among adults in Spain. GACETA SANITARIA 2015; 29 Suppl 1:43-8. [PMID: 26342420 DOI: 10.1016/j.gaceta.2015.01.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Revised: 01/14/2015] [Accepted: 01/19/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Road traffic accidents cause substantial morbidity and disease burden; few studies have examined their impact on disability. OBJECTIVE To estimate the magnitude and distribution of disability due to road traffic accidents according to socio-demographic variables, and its main socioeconomic and health determinants. METHODS A cross-sectional study was conducted in community-dwelling participants in the "2008 Spanish National Disability Survey", a representative sample of 91,846 households with 20,425 disabled persons older than 15 years; 443 had disability due to road traffic accidents. RESULTS The prevalence was 2.1 per 1000 inhabitants (95% CI:1.8-2.3), with no differences by sex. Risk was highest among persons aged 31 to 64 years, and onset of disability showed a sharp inflection point at age 16 years in both sexes. Odds ratios (ORs) were higher (OR=1.3; 95% CI:1.1- 1.7) for participants with secondary education than for those with the lowest educational levels and were lower (OR: 0.5; 95% CI:0.3-0.8) for participants with the highest household income levels than for those with lowest. Only 24% of disabled participants were gainfully employed. As compared to other sources of disability, traffic crashes caused greater disability in terms of mobility (OR=3.1;p<0.001), a greater need for health/social services (OR=1.5;p=0.003), and more problems with private transportation (OR=1.6;p<0.001), moving around outside the home (OR=1.6;p<0.001) and changes in economic activity (OR=2.4;p<0.001). CONCLUSIONS The prevalence of disability due to road traffic accidents in Spain is lower than in other developed countries, with middle-aged and socio-economically underprivileged persons being the most affected. Disability due to road traffic accidents is related to a greater demand for social/health care support, problems of accessibility/commuting, and major changes in economic activity.
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Affiliation(s)
- Rocío Palmera-Suárez
- Area of epidemiological analysis and health situation, National Centre for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain; Research Centre Network for Epidemiology and Public Health (CIBERESP), National Centre for Epidemiology, Instituto de Salud Carlos III Madrid, Spain.
| | - Teresa López-Cuadrado
- Area of epidemiological analysis and health situation, National Centre for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain; Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ, Madrid, Spain
| | - Javier Almazán-Isla
- Area of applied epidemiology, National Centre for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Rafael Fernández-Cuenca
- Area of epidemiological analysis and health situation, National Centre for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain; Research Centre Network for Epidemiology and Public Health (CIBERESP), National Centre for Epidemiology, Instituto de Salud Carlos III Madrid, Spain
| | - Enrique Alcalde-Cabero
- Area of applied epidemiology, National Centre for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Iñaki Galán
- Area of applied epidemiology, National Centre for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain; Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ, Madrid, Spain
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Røislien J, Lossius HM, Kristiansen T. Does transport time help explain the high trauma mortality rates in rural areas? New and traditional predictors assessed by new and traditional statistical methods. Inj Prev 2015; 21:367-73. [PMID: 25972600 PMCID: PMC4717406 DOI: 10.1136/injuryprev-2014-041473] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Accepted: 03/27/2015] [Indexed: 11/03/2022]
Abstract
BACKGROUND Trauma is a leading global cause of death. Trauma mortality rates are higher in rural areas, constituting a challenge for quality and equality in trauma care. The aim of the study was to explore population density and transport time to hospital care as possible predictors of geographical differences in mortality rates, and to what extent choice of statistical method might affect the analytical results and accompanying clinical conclusions. METHODS Using data from the Norwegian Cause of Death registry, deaths from external causes 1998-2007 were analysed. Norway consists of 434 municipalities, and municipality population density and travel time to hospital care were entered as predictors of municipality mortality rates in univariate and multiple regression models of increasing model complexity. We fitted linear regression models with continuous and categorised predictors, as well as piecewise linear and generalised additive models (GAMs). Models were compared using Akaike's information criterion (AIC). RESULTS Population density was an independent predictor of trauma mortality rates, while the contribution of transport time to hospital care was highly dependent on choice of statistical model. A multiple GAM or piecewise linear model was superior, and similar, in terms of AIC. However, while transport time was statistically significant in multiple models with piecewise linear or categorised predictors, it was not in GAM or standard linear regression. CONCLUSIONS Population density is an independent predictor of trauma mortality rates. The added explanatory value of transport time to hospital care is marginal and model-dependent, highlighting the importance of exploring several statistical models when studying complex associations in observational data.
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Affiliation(s)
- Jo Røislien
- Department of Health Sciences, University of Stavanger, Stavanger, Norway Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Hans Morten Lossius
- Department of Health Sciences, University of Stavanger, Stavanger, Norway Department of Research, Norwegian Air Ambulance Foundation, Drøbak, Norway
| | - Thomas Kristiansen
- Department of Research, Norwegian Air Ambulance Foundation, Drøbak, Norway Department of Anaesthesiology, Vestre Viken Hospital Trust, Drammen, Norway
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Brattström O, Eriksson M, Larsson E, Oldner A. Socio-economic status and co-morbidity as risk factors for trauma. Eur J Epidemiol 2014; 30:151-7. [PMID: 25377535 DOI: 10.1007/s10654-014-9969-1] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2014] [Accepted: 10/25/2014] [Indexed: 12/17/2022]
Abstract
Clinical experience and previous studies indicate that low socioeconomic positions are overrepresented in trauma populations. The reason for this social variation in injury risk is likely to be multifactorial. Both individual and environmental sources of explanation are plausible to contribute. We investigated the impact of the influence of socioeconomic factors and co-morbidity on the risk of becoming a trauma victim in a case-control study including 7,382 trauma patients matched in a one to five ratio with controls matched by age-, gender- and municipality from a level 1 trauma centre. Data from the trauma cohort were linked to national registries. Associations between socioeconomic factors and co-morbidity were estimated by conditional logistic regression. The trauma patients had been treated for psychiatric, substance abuse and somatic diagnoses to a higher extent than the controls. In the conditional logistic regression analysis a low level of education and income as well as co-morbidity (divided into psychiatric, substance abuse and somatic diagnoses) were all independent risk factors for trauma. Analysing patients with an injury severity score >15 separately did not alter the results, except for somatic diagnoses not being a risk factor. Recent treatment for substance abuse significantly increased the risk for trauma. Low level of education and income as well as psychiatric, substance abuse and somatic co-morbidity were all independent risk factors for trauma. Active substance abuse strongly influenced the risk for trauma and had a time dependent pattern. These insights can facilitate future implementation of injury prevention strategies tailored to specific risk groups.
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Affiliation(s)
- Olof Brattström
- Section of Anaesthesiology and Intensive Care Medicine, Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden,
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Bates LJ, Davey J, Watson B, King MJ, Armstrong K. Factors Contributing to Crashes among Young Drivers. Sultan Qaboos Univ Med J 2014; 14:e297-e305. [PMID: 25097763 PMCID: PMC4117653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Revised: 04/02/2014] [Accepted: 04/24/2014] [Indexed: 06/03/2023] Open
Abstract
Young drivers are the group of drivers most likely to crash. There are a number of factors that contribute to the high crash risk experienced by these drivers. While some of these factors are intrinsic to the young driver, such as their age, gender or driving skill, others relate to social factors and when and how often they drive. This article reviews the factors that affect the risk of young drivers crashing to enable a fuller understanding of why this risk is so high in order to assist in developing effective countermeasures.
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Affiliation(s)
- Lyndel J. Bates
- School of Criminology & Criminal Justice, Griffith University, Mount Gravatt, Queensland, Australia
- Centre for Accident Research & Road Safety, School of Psychology & Counselling, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Jeremy Davey
- Centre for Accident Research & Road Safety, School of Psychology & Counselling, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Barry Watson
- Centre for Accident Research & Road Safety, School of Psychology & Counselling, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Mark J. King
- Centre for Accident Research & Road Safety, School of Psychology & Counselling, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Kerry Armstrong
- Centre for Accident Research & Road Safety, School of Psychology & Counselling, Queensland University of Technology, Brisbane, Queensland, Australia
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Monárrez-Espino J, Möller J, Berg HY, Kalani M, Laflamme L. Analgesics and road traffic crashes in senior drivers: an epidemiological review and explorative meta-analysis on opioids. ACCIDENT; ANALYSIS AND PREVENTION 2013; 57:157-164. [PMID: 23685567 DOI: 10.1016/j.aap.2013.04.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Revised: 04/03/2013] [Accepted: 04/10/2013] [Indexed: 06/02/2023]
Abstract
AIM To assess the epidemiological evidence associating the use of analgesics with the occurrence of road traffic crashes in senior drivers including a meta-analysis with specific focus on opioids. METHODS Systematic literature review of articles published between 1991 and 2012 retrieved from major databases using relevant key words. Eligible articles were fully reviewed and the main characteristics and results summarized. The methodological quality was assessed using the Newcastle-Ottawa Scale. Heterogeneity tests and forest and funnel plots were used as part of the meta-analysis on opioids. RESULTS From the potentially eligible articles, nine were selected (4 case-control, 1 case-crossover, and 4 cohort studies) of which four were of medium and five of high quality; seven investigated opioids and four non-steroidal anti-inflammatory drugs. Crash involvement (n=7) rather than responsibility (n=2) was investigated. Age and sex were the most common covariates adjusted for. Both opioids and non-steroidal anti-inflammatory drugs showed mixed results including differences across estimates between and within studies. A marginal positive effect was observed in the pooled analyses on opioids (n=6, OR 1.20; 95% CI 1.08-1.32). CONCLUSIONS The evidence is unconvincing in terms of number of studies, control of major confounders, and consistency of the results. The effect seen for opioids can be attributed to the lack of adjustment of key confounders such as concomitant illness or the consumption of alcohol or other psychoactive medications. There is a need for more efficient designs like larger population-based retrospective cohorts and nested case-control or case-crossover studies based on registers of high quality allowing adjustment for these factors and for the selection of unequivocal outcomes (e.g. drivers' responsibility) to produce more persuasive empirical evidence.
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Affiliation(s)
- Joel Monárrez-Espino
- Department of Public Health Sciences, Karolinska Institutet, Tomtebodavägen 18A, Widerströmska huset, 17177 Stockholm, Sweden.
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Affiliation(s)
- S Audrey
- School of Social and Community Medicine, University of Bristol, , Bristol, UK
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Chen H, Du W, Li N, Chen G, Zheng X. The socioeconomic inequality in traffic-related disability among Chinese adults: the application of concentration index. ACCIDENT; ANALYSIS AND PREVENTION 2013; 55:101-106. [PMID: 23523896 DOI: 10.1016/j.aap.2013.02.025] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2012] [Revised: 02/18/2013] [Accepted: 02/19/2013] [Indexed: 06/02/2023]
Abstract
Traffic crashes have become the fifth leading cause of burden of diseases and injuries in China. More importantly, it may further aggravate the degree of health inequality among Chinese population, which is still under-investigated. Based on a nationally representative data, we calculated the concentration index (CI) to measure the socioeconomic inequality in traffic-related disability (TRD), and decomposed CI into potential sources of the inequality. Results show that more than 1.5 million Chinese adults were disabled by traffic crashes and the adults with financial disadvantage bear disproportionately heavier burden of TRD. Besides, strategies of reducing income inequality and protecting the safety of poor road users, are of great importance. Residence appears to counteract the socioeconomic inequality in TRD, however, it does not necessarily come to an optimistic conclusion. In addition to the worrying income gap between rural and urban areas, other possible mechanisms, e.g. the low level of post-crash medical resources in rural area, need further studies. China is one of the developing countries undergoing fast motorization and our findings could provide other countries in similar context with some insights about how to maintain socioeconomic equality in road safety.
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Affiliation(s)
- He Chen
- Institute of Population Research, Peking University, Beijing 100871, China.
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Falster MO, Randall DA, Lujic S, Ivers R, Leyland AH, Jorm LR. Disentangling the impacts of geography and Aboriginality on serious road transport injuries in New South Wales. ACCIDENT; ANALYSIS AND PREVENTION 2013; 54:32-38. [PMID: 23474235 DOI: 10.1016/j.aap.2013.01.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2012] [Revised: 12/21/2012] [Accepted: 01/28/2013] [Indexed: 06/01/2023]
Abstract
Aboriginal people in Australia have higher rates of transport injury than non-Aboriginal people, but a greater proportion of Aboriginal people live in rural or remote areas where risk of these injuries is higher. This paper investigated the contributing effect of geography on the relationship between Aboriginality and road transport injury rates in the state of New South Wales. Linked hospital admission and mortality records for individuals for the years 2001-2007 were grouped into distinct injury events. Multilevel Poisson regression was used to examine disparities in injury rates between Aboriginal and non-Aboriginal people clustered within geographic areas of residence. Overall, Aboriginal people had higher rates of road transport injuries (IRR: 1.18, 95% CIs: 1.09-1.28). However, there was no significant difference when geographic clustering was taken into account (IRR: 1.00, 95% CIs: 0.96-1.04). This effect was further influenced by mode of transport for the injury, with Aboriginal people having higher rates of pedestrian (IRR: 1.96, 95% CIs: 1.75-2.19) and lower rates of motorcycle (IRR: 0.64, 95% CIs: 0.59-0.70) injuries in all almost all local areas, while there was no systematic pattern across geographic areas for small vehicle injuries (IRR: 1.01, 95% CIs: 0.94-1.08). Geography plays an important role in the population disparity of road transport injuries between Aboriginal and non-Aboriginal people, and has a differential impact for different types of road transport injury. Exploring how individual and geographic factors influence patterns of disparity allows for clearer targeting of future intervention strategies.
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Affiliation(s)
- Michael O Falster
- University of Western Sydney, Locked Bag 1797, Penrith, NSW 2751, Australia.
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Hanna CL, Laflamme L, Bingham CR. Fatal crash involvement of unlicensed young drivers: county level differences according to material deprivation and urbanicity in the United States. ACCIDENT; ANALYSIS AND PREVENTION 2012; 45:291-295. [PMID: 22269512 DOI: 10.1016/j.aap.2011.07.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2011] [Revised: 07/19/2011] [Accepted: 07/21/2011] [Indexed: 05/31/2023]
Abstract
OBJECTIVES This study assessed the association between county level material deprivation and urbanization with fatal road traffic crashes involving young unlicensed drivers in the United States (US). BACKGROUND Road traffic crashes have been positively associated with area deprivation and low population density but thus far few studies have been concerned specifically with young drivers, especially those that are unlicensed. METHODS A county material deprivation index was derived from the Townsend Material Deprivation Index, with variables extracted from the US Census (2000). An urbanicity scale was adapted from the US Department of Agriculture's Rural-Urban Continuum Codes (2003). Data on fatal crashes involving a young unlicensed driver during a seven-year period (2000-2006; n=3059) were extracted from the Fatality Analysis Reporting System. The effect of deprivation and urbanicity on the odds of the occurrence of at least one fatal crash at the county level was modeled by conditional and unconditional logistic regression. RESULTS The conditional model found a positive association between material deprivation and a fatal crash involving a young unlicensed driver (OR=1.19, 95% CI 1.17, 1.21). The interaction between urbanicity and material deprivation was negatively associated in suburban counties for fatal crashes (OR=0.92, 95% CI 0.90, 0.95). CONCLUSIONS An association with material deprivation and the likelihood of a fatal crash involving a young unlicensed driver is a new finding. It can be used to inform specific county-level interventions and promote state licensing policies to provide equity in young people's mobility regardless of where they live.
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Affiliation(s)
- Christian L Hanna
- Karolinska Institutet, Department of Public Health Sciences, Division of Global Health, SE-17177 Stockholm, Sweden.
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Kristensen P, Kristiansen T, Rehn M, Gravseth HM, Bjerkedal T. Social inequalities in road traffic deaths at age 16-20 years among all 611,654 Norwegians born between 1967 and 1976: a multilevel analysis. Inj Prev 2011; 18:3-9. [PMID: 21606470 PMCID: PMC3262988 DOI: 10.1136/ip.2011.031682] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Road traffic injury is a major cause of death among youths. Aims To estimate mortality differences in family socioeconomic position (SEP) and municipal disadvantage level. Methods Data on all Norwegians born in 1967–76, gathered from national registries, were linked by a unique national identification number. The 611 654 participants were followed-up for 5 years from age 16 years. Parental education level, father's income level, and proportion of high-income earners in the municipality served as SEP indicators. Associations between SEP and road traffic deaths were analysed by multilevel Poisson regression. Results Road traffic deaths (n=676, rate 22.2 per 100 000 person-years) constituted a major cause of death, of which 91.9% were motor vehicle occupants. SEP distributions differed according to gender and type of motor vehicle crash (collision, non-collision). There was an inverse relationship between municipal proportions of high-income earners and mortality (population attributable fraction (PAF) 0.43, 95% CI 0.30 to 0.53) in all categories of gender-specific crash types. Family SEP gradients were not found except for male non-collision deaths, where increasing mortality was found in association with decreasing parental education level (PAF 0.94, 95% CI 0.59 to 0.99) and increasing paternal income (PAF 0.25, 95% CI 0.06 to 0.40). Conclusion The different SEP patterns for road traffic deaths across gender and motor vehicle crash type illustrate that heterogeneity of social inequalities in health can be found even within narrow age bands and for similar causes of death.
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Affiliation(s)
- Petter Kristensen
- Department of Community Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway.
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Chen HY, Senserrick T, Martiniuk ALC, Ivers RQ, Boufous S, Chang HY, Norton R. Fatal crash trends for Australian young drivers 1997-2007: geographic and socioeconomic differentials. JOURNAL OF SAFETY RESEARCH 2010; 41:123-128. [PMID: 20497797 DOI: 10.1016/j.jsr.2009.12.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2009] [Accepted: 12/15/2009] [Indexed: 05/29/2023]
Abstract
BACKGROUND Little has been published on changes in young driver fatality rates over time. This paper examines differences in Australian young driver fatality rates over the last decade, examining important risk factors including place of residence and socioeconomic status (SES). METHODS Young driver (17-25years) police-recorded passenger vehicle crashes were extracted from New South Wales State records from 1997-2007. Rurality of residence and SES were classified into three levels based on drivers' residential postcode: urban, regional, or rural; and high, moderate, or low SES areas. Geographic and SES disparities in trends of fatality rates were examined by the generalized linear model. Chi-square trend test was used to examine the distributions of posted speed limits, drinking driving, fatigue, seatbelt use, vehicle age, night-time driving, and the time from crash to death across rurality and socioeconomic status. RESULTS Young driver fatality rate significantly decreased 5% per year (p<0.05); however, stratified analyses (by rurality and by SES) showed that only the reduction among urban drivers was significant (average 5% decrease per year, p<0.01). The higher relative risk of fatality for rural versus urban drivers, and for drivers of low versus high SES remained unchanged over the last decade. High posted speed limits, fatigue, drink driving and seatbelt non-use were significantly associated with rural fatalities, whereas high posted speed limit, fatigue, and driving an older vehicle were significantly related to low SES fatality. CONCLUSION The constant geographic and SES disparities in young driver fatality rates highlight safety inequities for those living in rural areas and those of low SES. Better targeted interventions are needed, including attention to behavioral risk factors and vehicle age.
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Affiliation(s)
- H Y Chen
- The George Institute for International Health, The University of Sydney. Postal address: PO Box M201 Missenden Road, Sydney, NSW 2050.
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